Enrollment in Arkansas' Medicaid expansion program, known as Arkansas Works, increased by 2,100 people in October, to almost 310,000, the Arkansas Department of Human Services reported Monday.
During the same month, the average monthly cost per enrollee fell by $3.69, to $518.63, the department reported.
Approved by the Republican-controlled Legislature and then-Gov. Mike Beebe, a Democrat, in 2013, the Medicaid expansion extended eligibility to adults with incomes of up to 138 percent of the poverty level: $16,643 for an individual, for instance, or $33,948 for a family of four.
Concerned about the eventual cost of the program, Gov. Asa Hutchinson has requested federal approval to move about 60,000 people off the program by limiting eligibility to people with incomes up to the poverty level, and to impose a work requirement on many of those remaining.
State officials hadn't received approval for the request as of Monday but are "optimistic it will happen soon," Human Services Department spokesman Amy Webb said in an email.
Once approved, the changes will take about 60 days to implement, Webb has said.
The 309,719 people enrolled as of Oct. 31 included 286,868 people who were assigned to coverage in private plans offered on the state's insurance exchange under the so-called private option.
The other 22,851 enrollees were being covered by the traditional, fee-for-service Medicaid program because they were considered "medically frail," with health needs that private plans don't typically cover.
Total enrollment in the program has fluctuated over the past few months but remains lower than it was at the beginning of the year, when the number exceeded 330,000.
Under the 2010 Patient Protection and Affordable Care Act, the federal government paid the full cost of the program through 2016. Arkansas became responsible for 5 percent of the cost this year. The state's share will rise to 6 percent next year and keep increasing each year until it reaches 10 percent in 2020.
The cost in October included an average payment to insurance companies of $514.62 per enrollee, down $3.79 from September.
The Medicaid program also paid an average of $4.01 per enrollee for benefits, such as nonemergency medical transportation, that the private plans don't cover. That was an increase of 10 cents per enrollee for such benefits in September.
Under the federal waiver authorizing Arkansas Works, the state will owe additional money to the federal government if the cost of the private option from 2017-2021 exceeds a limit that will be calculated based on monthly caps, which increase each year.
The cap this year is $570.50. Through October, the program's cost averaged $524.72.
Metro on 12/05/2017